I am a fan of books that offer practical know-how for negotiating life's up's and down's, and am an author myself of books and online self-help materials on topics such as depression, anxiety and how to fix a relationship. I am pleased to report therefore that reading fellow PT blogger Guy Winch's excellent new book Emotional First Aid proved to be a surprisingy powerful experience for me.

Winch addresses the emotional distress caused by common emotionally painful experiences including rejection, guilt, excessive rumination, loss, failure, low self-esteem, and loneliness. All of these negative phenomena occur from time to time to almost everyone, which may account for why they all-too-often pass under the radar of mental health professionals' main foci. While Winch explores all of these common emotional injuries with impressive clarity, the chapter on loneliness was, for me, most potent.

Here's why Winch's writings on loneliness impacted me so strongly.

Several months ago a young man I know, I'll refer to him here as Bill, committed suicide. Bill's difficulties were multifaceted, profound and of many years duration. His determination to end his life had been incubating for decades. The final impetus had come from a work-related rejection. Still, having just read Winch's description of how self-defeating cycles of self-isolation and intense loneliness can develop, I see now all too vividly how the pain of loneliness increased Bill's vulnerability, contributing sigificantly, alas, to his eventual decision to end his life.

Guy Winch, author and PT blogger

How long does loneliness usually last?

Winch clarifies that loneliness most often occurs as a transient emotional state. Many folks experience the pain of feeling cut off from close friends and families after a life transition such as a move to a new city, the ending of a marriage, or the loss of a loved one. Children are particularly prone to suffer waves of loneliness after a move to a new school or a new city. In general, as sad and isolated as folks in these circumstances may feel initially, the painful feelings gradually abate as people participate in the world, building new relationships that eventually replace the old.

The passage from acute to chronic loneliness.

What I had not understood however before reading the chapter on loneliness in Winch's Emotional First Aid is that some people who experience a period of loneliness find themselves unable to extricate from this state. Unsuccessful with regard to forming new attachments, they gradually develop patterns of ever-increasing isolation. Self-isolation deepens the loneliness, creating a self-defeating cycle of ever-increasing loneliness and isolation.

As lonely people reach out less and less to others, even hiding when other people with whom they might interact are nearby, their people hunger can grow to overwhelming proportions. Bill for instance would bring a book to read at work in the corner of the social lounge while his colleagues gathered to talk and laugh together. When a new neighbor, another single man, moved into the apartment next to his, Bill offered an initial impersonal hello-my-name-is and then never followed up by inviting the newcomer over for coffee or even proffering further greetings.

Winch's poignant description of how people who suffer ever-deepening and potentially terminal loneliness become increasingly isolated all-too-accurately described Bill's pattern. Bill felt deeply depressed about his isolation, and in his suffering become immobilized, unable to reach out to others or even to accept others' outreach gestures to him.

When a downward spiral of loneliness and self-isolation conveys to others disinterest in forming connections, recuperation becomes all the more difficult.

How can patterns of chronic loneiness be reversed?

Fortunately, Winch offers antidotes to patterns of ever-increasinging loneliness. With step-by-step suggestions and inspirational anecdotes, Winch shows how even small changes in behaviors and in ways of thinking can turn the downward spiral into an upward draft.

Winch suggests, for instance, clarifying the existing arenas in the lonely person's life where there are potential intersections with others that could be expanded. He illustrates then how to think through what a small very next step might be that would initiate incremental increases in interactions in these situations. For instance in one of his examples a lonely elderly man who played chess once a week gradually became friends with others in his weekly chess group by starting to say at least one or two pleasant comments to each of the other players every session.

Winch guides readers also to explore earlier life events where they might have learned negative lessons about interactions. These memories often were of unpleasant situations in which teasing, taunting or bullying launched subsequnet patterns of avoiding contact with others. My friend Bill for instance had been a very shy child. Teasing of the variety that young children often engage in had felt devastating to him.

In sum, I feel deeply appreciative to Guy Winch for his astute observations on so many common causes of emotional distress and their cures, and especially for the chapter on loneliness. While loneliness may not receive a DSM diagnostic label, without effective self-help from a book like Emotional First Aid(and in severe cases also professional help), loneliness can cause serious life-crippling repercussions and can even become terminal. Winch's perspectives have much to offer for anyone dealing with distressing circumstances, including mental health professionals like myself who help others to deal with emotional difficulties.

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Denver clinical psychologist Susan Heitler, Ph.D, a graduate of Harvard and NYU, is author of Power of Two, a book, a workbook, and a website that teach the communication skills for relationship readiness.

Click here for a free Power of Two relationship skills readiness test.

Click the Power of Two logo to learn the skills for strong, emotionally healthy relationships.

Ironically, I, a only child with a uninvolved father, never understood the feeling of loneliness until after marriage, two kids, which occurred in my late 30s, and turning 40. I am in my mid 40s now, still married and the feeling of being alone is stronger than ever. I even lived alone for a very long time previously without ever feeling this way. It is peculiar regardless, no?

Your note reminded me of a phenoenon I often observed when my children were young. They played happily by themselves---unless or until I picked up the phone and started talking on it. Suddenly they felt an urgent need to talk with me. Was it that hearing my voice reminded them of my presence and triggered therefore their wanting to talk with me? Or in talking on the phone did I seem to be turning my back on them? Or worse, turning toward others?

I am not sure I understand the connection. But no, I can't say that I have perceived that experience with my children.

I have a very close relationship with my family. We do a lot together and I am not unhappy. But still strangely, I feel a terrible loneliness. I did lose faith soon after my oldest was born so that may have something to do with it.

Or possibly it is the loss of my prior identity. I was a very independent person and now I'm not. I used to really enjoy my alone time. Possibly I haven't adjusted to the change yet in whole.

Kids suddenly feel lonely when mom is on the phone If they were just alone they would not feel lonely. Similarly, the presence of a marriage partner in your life could invite more loneliness when he is elsewhere, or when he is at home but with his attention turned somewhere other than toward you.

Loneliness can also occur as an aspect of depression. When you used to be "independent", what did you do then that was different from what you have been doing of late? Maybe you need to do more of that. Many women who used to work until their kids arrived for instance need to go back to work to get rid of that lonely, depressed, something's missing in my life feeling.

Your association with the loss of faith that happened after your oldest child was born is intriguing. It may pay off to think more about that connection...